If you're going to be building this block of code the same way in Perl i.e. using a sub then you could use return where it has Exit Sub.

I'm sorry I'm on Linux so can't text Win32 MAPI stuff for you, but if your piece of code:

if ($Inbox->Items->$Count == 0)
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works (by the way that's == for a test, not = which would be an assignment) then you could use:

return if ($Inbox->Items->$Count == 0);
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