To evaluate the results of using and removing silicone oil in the management of giant retinal tears, 24 cases of vitrectomy with fluid-silicone oil exchange were reviewed. We did not use cryotherapy in any case. For chorioretinal adherence, we used either endolaser or postoperative external laser and a narrow buckle. The retina was reattached successfully in 22 (91.6%) of the 24 eyes. Of these, visual acuity was 20/200 or better in 18 (75%) eyes. This was significantly better than the preoperative visual acuity (P = .02). After removing the silicone oil in 15 cases, 13 (92.8%) had visual acuities of 20/200 or better, which was considerably better than that of the group in which the silicone oil was not removed (P = .006). We recommend removing the silicone oil and additional peeling of membranes an average of six months postoperatively when the eye is stable.