The use of polydimethylsiloxane (PDMS) as silicone oil endotamponade has become a gold standard in retinal surgery. In cases of complicated retinal detachment with inferior and posterior retinal detachment this tamponade may be insufficient, and heavy silicone oils may be superior in such cases. Monocentric studies about use of the heavy silicone oil Densiron 68, a mixture of PDMS with perfluorohexyloctane (F6 H8), are reviewed. Meanwhile, F 6 H8 is approved as sole endotamponade, but complications such as emulsification and inflammation associated with the use of only F 6 H8 as endotamponade are reported and will also be reviewed. An advantage of heavy silicone oils is the relatively short residence time of the endotamponade. An uncomfortable "head down" position of the patients after surgery is not necessary. Current research focuses on developing new heavy silicone oils with a lower tendency to emulsify.