Abstract Purpose To evaluate the factors affecting the anatomic success of treatment of retinal detach- ments (RD) by scleral buckling surgery. Methods One-hundred and two eyes of 102 patients with rhegmatogenous RD operated on by scleral buckling surgery were included in the study. Results were analyzed according to the anatomic status of the retina at the most recent follow-up examination. The chi-squared test was used to determine the relationship between preoperative and intraoperative variables and anatomic results, and the relative risk of failure was determined for each variable. Results Retinal reattachment was achieved in 85 of 102 eyes (82.5%) after initial surgery. The success rate for anatomic reattachment was 95% after two operations. After three operations reattachment was achieved for 98 eyes (96%). Predictive factors for anatomic failure (P < 0.05) were the presence of grade C 1 PVR and multiple breaks. Conclusion Grade C 1 PVR and multiple breaks were found to be significant risk factors for anatomic failure in rhegmatogenous RD treated by conventional buckling surgery. Keywords Anatomic success Æ Conventional buckling surgery Æ Rhegmatogenous retinal detachment Rhegmatogenous retinal detachment (RRD) can be treated by use of different surgical procedures. The scleral buckling procedure is regarded as appropriate treatment for many uncomplicated cases [1]. In complicated RD, however—i.e. those with giant retinal tears, vitreous hemorrhage, breaks at the posterior pole, or proliferative vitreoretinopathy (PVR)—pars plana vitrectomy with endotamponade is indicated. Most contem- porary reports of large, consecutive case series indicate that anatomic reattachment can be achieved in more than 90% of cases but that 10–20% of eyes require more than a single opera- tion to reattach the retina. Some preoperative, intraoperative, and postoperative factors are rela- ted to both the anatomic success rate and to visual results [2]. Our objective was to investigate the anatomic success rate of conventional buckling surgery in primary rhegmatogenous retinal detachment and The authors have no financial or proprietary interest in the products mentioned in the text F. Afrashi Æ C. Akkin Æ S. Egrilmez Æ T. Erakgun Æ J. Mentes Department of Ophthalmology, School of Medicine, Ege University, Bornova-Izmir 35100, Turkey F. Afrashi (&) Department of Ophthalmology, Ege University Hospital, Bornova-Izmir 35100, Turkey e-mail: afrashi@med.ege.edu.tr Int Ophthalmol (2005) 26:77–81 DOI 10.1007/s10792-006-9004-y 123 ORIGINAL PAPER Anatomic outcome of scleral buckling surgery in primary rhegmatogenous retinal detachment F. Afrashi Æ C. Akkin Æ S. Egrilmez Æ T. Erakgun Æ J. Mentes Received: 30 June 2004 / Accepted: 25 July 2006 / Published online: 7 September 2006 Ó Springer Science+Business Media B.V. 2006