OBJECTIVE: To investigate the effectiveness of vitrectomy repair in patients with severe open ocular trauma combined with choroidal detachment. METHODS: We retrospectively analyzed the clinical data of 23 eyes of 23 patients who underwent stage II vitrectomy for severe open ocular trauma from 2004 to 2010, and the surgery was performed by closed vitrectomy with silicone oil filling. Among them, 17 eyes had rupture injury, 6 eyes had penetrating injury, 10 eyes had corneoscleral injury, 13 eyes had scleral injury, 7 eyes had ciliary detachment, all of them had retinal detachment and choroidal detachment, blood accumulation in the vitreous cavity and suprachoroidal hemorrhage. The choroidal detachments were treated with different techniques to promote choroidal repositioning, such as increasing intraocular pressure, extra-scleral fluid release, suturing the choroidal fissure, and ciliary body suturing. Results: 18 eyes had choroidal repositioning, 5 of which had complete repositioning of choroidal detachment, 6 eyes had limited choroidal detachment that did not affect the integrity of the eye, and 7 eyes required long-term silicone oil filling due to low intraocular pressure. 5 eyes had removal of the eye. Conclusion: Severe open ocular trauma combined with choroidal detachment is complex and the prognosis is often poor. Early (within 1 week) timely and reasonable vitrectomy treatment can result in a better anatomical repositioning of the injured eye and some patients can improve their visual acuity.