AIM: To investigate the effects of shortening the duration of silicone oil tamponade on retinal structure and function in patients undergoing silicone oil removal (SOR) after surgery for primary rhegmatogenous retinal detachment (RRD). METHODS: A total of 58 eligible patients were enrolled and randomly assigned to two groups based on tamponade duration: the short-term group (30-45d) and the conventional group (≥90d). Comprehensive evaluations were performed before and after SOR, including slit-lamp examination, best-corrected visual acuity (BCVA) measurement, intraocular pressure (IOP) testing, optical coherence tomography (OCT), optical coherence tomography angiography (OCTA), microperimetry, electroretinography (ERG), and visual evoked potential (VEP) assessment. RESULTS: A total of 33 patients (23 males and 10 females; 33 eyes) were enrolled in the short-term SO tamponade group with mean age of 52.45±9.35y, and 25 patients (15 males and 10 females; 25 eyes) were enrolled in the conventional SO tamponade group with mean age of 50.80±12.06y. Compared with the conventional group, the short-term silicone oil tamponade group had a significantly lower incidence of silicone oil emulsification and cataract progression, with no significant difference in retinal reattachment success rate. Structurally, short-term tamponade was associated with increased thickness of the retinal ganglion cell layer (RGCL) in the nasal and superior macular regions and improved recovery of superficial retinal vascular density in these areas. Functionally, the short-term group showed better BCVA and retinal sensitivity both before and 1mo after SOR; additionally, the P100 amplitude in VEP tests was significantly increased in this group. CONCLUSION: Shortening the duration of silicone oil tamponade effectively reduces damage to retinal structure and function without compromising the success rate of retinal reattachment in patients with primary RRD.