AIM:To observe the long-term results of the macula-off rhegmatogenous retinal detachment(RRD)with optical coherence tomography(OCT)after scleral buckling and to analyze the relation between duration of macular detachment and postoperative best-corrected visual acuity(BCVA)with OCT image.METHODS:Retrospective 5 years follow-up of 47 eyes of 47 patients with macula-off RRD was involved.A microscopic fundus examination was conducted followed by Topcon OCT to assess the postoperative foveal microstructure.The correlation between the postoperative BCVA and microstructural findings at the fovea were evaluated.Images of the foveal microstructure were obtained by OCT and the BCVA was measured on the same day.Patients were divided into duration of macula detachment(DMD)less than 7 days and more than 7 days.RESULTS:Indirect ophthalmoscope indicated that all retinal detachments were reattached 5 years after operation.OCT showed that accumulation of subretinal fluid and macular neurosensory tissue accumulation at the fovea was in 1 eye(2%)respectively.And the mean visual acuity of these 2 patients was 0.13 after 5 years,which was significantly lower than that in the other 45 patients(without subretinal fluid)(0.54)(Student’s t test,P=0.025).CONCLUSION:The time of macula-off RRD has great influence on the recovery of visual acuity,which is a negative correlation,while visual acuity in the long period of time will increase to varying degrees,postoperative retinal thickness and visual acuity was positively correlated.We suggest that patients with good reattachment poor vision after reset should be performed OCT scans in order to discover the reasons for poor vision.This study assessed clinical prediction of macular retinal detachment surgery and potential restoration of visual function to provide the basis for the situation.