The authors conducted a retrospective review of 32 patients with posterior retinal folds following retinal reattachment surgery. Twenty-eight of these patients underwent combined pars plana vitrectomy, fluid-air exchange with either internal drainage through a preexisting retinal break or external drainage of subretinal fluid, and scleral buckle. We believe these drainage techniques resulted in incomplete elimination of subretinal fluid, with resultant sequestration of fluid at the dependent border between attached and detached retina. Metamorphopsia and decreased visual acuity were noted in patients with folds involving the macula. The likelihood of fold formation may be greatly reduced by internal drainage through a posterior retinotomy combined with more complete removal of slowly gravitating fluid as it flows dependently to the drainage site.