Six hundred consecutive retinal detachments were operated on with silicone scleral buckles. Twenty-three implants, or 3.8%, were removed. There was one solid silicone implant and 22 silicone sponges. Removal was required because of infection (seven eyes), foreign-body sensation without infection (seven eyes), recurrent subconjunctival hemorrhages (four eyes), impingement on the optic nerve (one eye), and distortion of the macula (four eyes). The postoperative infection rate was 1.8% for silicone sponges, and there were no infections in eyes buckled with solid silicone. Only one retina redetached after buckle removal, yielding a recurrence rate of 4%. The one recurrence was successfully managed by a second scleral buckle.