PURPOSE OF REVIEW: This article reviews operative techniques and risks associated with microincision vitrectomy surgery. RECENT FINDINGS: All three microincision vitrectomy surgery platforms (23, 25, and 27 gauge) are associated with both advantages and disadvantages, combined with similarly low rates of hypotony, endophthalmitis, corneal astigmatism, and postoperative inflammation. SUMMARY: Hybrid-gauge vitrectomy, utilizing larger gauge MIVS cannulas, preserves surgeon access to benefits of both larger and smaller gauge MIVS platforms without compromising safety, efficacy, or efficiency.