Objective To compare modified pneumatic retinopexy (PR) and conventional scleral buckling (SB) for repair of primary rhegmatogenous retinal detachment with respect to long-term effect and complications .Method Forty-three patients presention with retinal detachments, which retinal breaks located in the superior six clock hours of the ocular fundus, were repaired by either PR or SB, twenty-three patients inPR group and twenty patients in PR group.Comparative analysis of the clinical data in the two groups was made.An average follow-up of 32 months was obained.Results Best-corrected visual acuity of 19 eye simproved two lines and more in PR group.The overall reattachment rate with reoperation in both groups was 100% .In cases of patients only with superior retinal hole,86.67% single-procedure reattachment rate was achieved in PR group ,and 90.91% in SB group.Complications in PR group included new and missed retinal breaks,delayed absorption of subretinal fluid,PVR and cataract .No Significant difference was found in best-corrected visual acuity, single-procedure reattachment rate and complications between PR group and SB group.Conclusions Modified pneumatic retinopexy is an effective and safe surgery for retinal detachments with superior breaks.In cases of patients only with superior retinal hole,pneumatic rctinopexy can reach the same therapeutic effect of scleral buckling.