$re = '/^<img src="index-(?![12]_)(\d+)_\d+\.(?:jpg|png)"\/><br>$/m';
$str = '<img src="index-1_2.jpg"/><br>
<img src="index-1_3.jpg"/><br>
<img src="index-1_5.jpg"/><br>
<img src="index-2_1.jpg"/><br>
<img src="index-2_5.jpg"/><br>
<img src="index-3_1.png"/><br>
<img src="index-23_8.png"/><br>
<img src="index-22_9.png"/><br>
<img src="index-22_1.jpg"/><br>
<img src="index-22_2.jpg"/><br>
<img src="index-99_5.png"/><br>
<img src="index-100_5.png"/><br>
<img src="index-1000_5.png"/><br>';
$subst = "$1";
$result = preg_replace($re, $subst, $str);
echo "The result of the substitution is ".$result;
Please keep in mind that these code samples are automatically generated and are not guaranteed to work. If you find any syntax errors, feel free to submit a bug report. For a full regex reference for PHP, please visit: http://php.net/manual/en/ref.pcre.php