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 6 months, complete anatomic retinal reattachment posterior to the encircling scleral buckle was obtained in 64% of these eyes. Ambulatory visual acuity (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. Because of the frequent and severe complications associated with the use of silicone oil, we recommend that silicone-oil injection be considered only when conventional vitreoretinal techniques have failed to achieve retinal reattachment.