We conducted a prospective study of 226 eyes with nontraumatic rhegmatogenous retinal detachment; we examined patient characteristics as well as changes in axial length and corneal curvature induced by scleral buckling surgery. Eyes with a round hole in lattice degeneration were characterized by axial length that was longer than that of eyes with retinal tears with and without lattice degeneration. Sex and age also correlated significantly with axial length. Surgically induced changes in axial length depended upon the procedures performed, but the retinal detachment surgery primarily caused a change in the refractive status.