To compare the implant and explant techniques of scleral buckling.This prospective, randomized clinical study compared the two techniques of scleral buckling. Variables such as size and extent of the buckle, duration of the surgery, complications, and anatomical and visual outcome were studied. The height of the buckle as measured by ultrasonography was also studied.No significant difference was found between the two groups for total duration of the surgery, complications, anatomical results, visual outcome, and buckle height. For the 1- to 2-quadrant buckles, duration of the surgery up to initiation of subretinal fluid drainage was found to be significantly shorter for the explant group. Serial ultrasonography showed significant reduction in buckle height over 6 months in both groups to an equal degree.Scleral buckling seems to be equally effective whether performed as an implant or explant.