OBJECTIVE:To evaluate the effect of scleral buckling surgery on the treatment of hypotony caused by choroidal holes and suprachoroidal silicone oil (SO) migration following surgical procedures for open globe injuries. DESIGN:Retrospective, consecutive, interventional case series. PARTICIPANTS:Ten eyes of 10 patients with hypotony caused by choroidal holes with suprachoroidal SO migration and choroidal detachment after vitrectomy for open globe injuries between October 2009 and December 2010. METHODS:All cases clinically diagnosed as hypotony caused by choroidal holes with suprachoroidal SO migration and choroidal detachment were identified. Those eyes with retinal detachment, ciliary body damage, ciliary body fibrosis, or cyclodialysis cleft were excluded. Scleral buckling with or without suprachoroidal SO drainage was performed. RESULTS:The mean preoperative intraocular pressure (IOP) was 6.7 ± 1.4 mm Hg (5.3-9.0 mm Hg). The mean final follow-up IOP was 12.2 ± 4.7 mm Hg (7.0-21.0 mm Hg; p = 0.005). In 7 eyes, the IOP increased to ≥10 mm Hg, whereas 3 eyes showed no significant IOP elevations. The choroidal hole was closed, and the range of choroidal detachment was significantly reduced in those 7 eyes. Although the choroidal hole was not fully closed in 3 eyes, the choroidal detachment area was less extensive, and the IOP was stable at approximately 7 mm Hg. CONCLUSION:Scleral buckling surgery combined with suprachoroidal SO drainage is an effective way to manage hypotony caused by choroidal holes and suprachoroidal SO migration in a SO-filled eye after vitrectomy for open globe injuries.