We have used silicone oil injection in a consecutive series of 44 patients with retinal detachment and advanced proliferative vitreoretinopathy, all of whom had previously failed to reattach with vitrectomy, membrane peeling, and scleral buckling. After a minimal follow-up period of six months, complete anatomic retinal reattachment posterior to the encircling scleral buckle was obtained in 64% of these eyes, and visual acuity of 5/200 or better was achieved in 57% of the anatomically successful cases. Silicone oil removal was performed in 69% of the anatomically and visually successful eyes without recurrent retinal detachment.