AIM: To investigate the correlation between retinal microstructural changes and visual function after scleral buckling and vitrectomy with rhegmatogenous retinal detachment.

METHODS: Prospective clinical study was conducted. With PVR grade B-C1, 75 patients with 75 eyes of aged 15-30 years who were macular-off retinal detachment were selected. PPV was performed for posterior equatorial retinal hiatus(35 eyes, PPV group), and SB was performed for anterior equatorial retinal hiatus(40 eyes, SB group).The patients in the two groups were followed up for 6mo to observe the changes in the best corrected visual acuity(BCVA)and retinal microstructures.

RESULTS: Compared with SB group, the probability of inner sensory layer/outer sensory layer and inner boundary membrane fracture after operation in PPV group was 2.812 times, with a statistically significant difference(P=0.020), and the probability of subretinal effusion was 0.115 times, with a statistically significant difference(P<0.001). There was no statistically significant difference(P=0.700)between the two groups. And with the extension of observation time, the possibility of inner sensory layer/outer sensory layer and inner boundary membrane, persistent subretinal fluid and interlayer effusion in the two groups of patients gradually decreased. After the operation, the thickness of the neurosensory retinal and outer nuclear layer in the two groups gradually increased, and BCVA gradually improved. With the prolonging of observation time, the thickness of the neurosensory retinal in SB group increased greatly, and BCVA recovered better.

CONCLUSION: The integrity of the inner sensory layer/outer sensory layer and inner boundary membrane, subretinal effusion, interlaminar effusion, and the thickness of the neurosensory retinal are the key factors affecting the recovery of visual function after SB or PPV.