One hundred consecutive pneumatic retinopexy eligible eyes underwent outpatient scleral buckle and diathermy. Follow-up averaged 31 months. Four cases required a second operation. Absence of an encircling band was the only significant risk factor (P = 0.00000028) for the three redetachments because of new or missed retinal tears. Although 18 patients had some other disease that reduced visual acuity before the retina detached, final visual acuity was 20/40 or better in 79 patients. Matched with a reported series treated by pneumatic retinopexy with cryopexy, these scleral buckle with diathermy cases exhibit significantly better final visual acuity with fewer major complications. The final acuity is also better than for two similar series, one treated with temporary balloon buckle and the second with scleral buckle and cryopexy. Use of diathermy rather than cryotherapy in the zone of retinal detachment may be the reason for the current group's better final acuity results.