A total of 42 cases (42 eyes) with silicone oil in the anterior chamber after pars plana vitrectomy (PPV) and after silicone oil injection into the vitreous cavity (SIV) were analyzed. The main complications caused by silicone oil were corneal endothelial cell damage and secondary glaucoma. Specular microscopy showed decreased cell density, apparent pleomorphism of endothelial cells, and increased corneal thickness. In some cases, edematous and necrotic endothelial cells were found. The characteristic optical artifacts resulting from silicone oil coming into contact with the endothelium, such as a bright reflex, reversed pattern of illumination, and interference fringes, were also observed. There was a definite correlation between elevated intraocular pressure (IOP) and the presence of silicone oil in the anterior chamber; the IOP dropped significantly on removal of the oil. The treatment and prevention of conditions involving silicone oil in the anterior chamber are briefly discussed.