Although we found that the risk of endophthalmitis is significantly lower after MIVS compared to conventional 20-G vitrectomy, caution is warranted in interpreting this finding. As the incidence rates of endophthalmitis after 20-G vitrectomy and MIVS represent different study periods, comparing the two may not reflect the true difference. Since the first introduction of 25-G vitrectomy by Fujii et al. in 2002, the incisional techniques and technology of MIVS have evolved considerably, exemplified by the reported of decreasing incidence of endophthalmitis in the last decade. At best, our results suggest no increased risk of endophthalmitis after MIVS.