Objective To explore the application values of optical coherence tomography (OCT) in postoperation of patients with rhegmatogenous retinal detachment (RRD). Methods A total of 120 cases of RRD patients (120 affected eyes, 120 healthy eyes) admitted to our hospital from June 2014 to June 2017 were enrolled in this study and were given the scleral buckling surgery. The best corrected visual acuity (BCVA) was determined by comprehensive ophthalmoscopy after operation, and the OCT was performed on both eyes at the follow-up of 3d, 2 weeks, 1 month, 3 months and 6 months after operation. The macular foveal retinal thickness, subretinal macular fluid (SMF) height and the photoreceptor inner segment/outer segment (IS/OS) borderline and the external limiting membrane (ELM) and other microstructures were measured. And the relationship between macular microstructure changes and visual acuity prognosis after operation was analyzed. Results The preoperative OCT showed that the IS/OS and ELM layers were ruptured, and the photoreceptor outer reflection band was irregular or thickening. The postoperative IS/OS and ELM morphology were mainly continuous IS/ OS and ELM, ruptured IS/OS and continuous ELM, continuous IS/OS and ruptured ELM, and ruptured IS/OS and ELM. The BCVA of affected eyes was increased with different degree at 2w after operation, and the BCVA at 3 months and 6 months after operation was significantly higher than that before operation (P<0.05). The preoperative SMF height and the macular foveal retinal thickness of the affected eyes were higher than those of the contralateral healthy eyes (P<0.01), and the macular foveal retinal thickness at 3d, 2 weeks, 1 month and 3 months after operation was lower than that before operation but was still higher than that of contralateral healthy eyes (P<0.01), but there was no significant difference at 6 months after operation (P>0.05). Preoperative SMF height, macular foveal retinal thickness were negatively correlated with the BCVA of affected eyes at 6 months after operation (P<0.05). Conclusion OCT in the postoperation of RRD has high application values, which can evaluate its macular foveal retinal thickness, SMF, IS/ OS, ELM and other microstructures, and it is worthy of clinical promotion and practice.