AIM: To investigate the outcome of combined anterior corneal elastic sublaminectomy, conjunctival flap, and prosthetic eyepiece for ocular atrophy following foldable capsular vitreous body (FCVB) implantation in severe trauma. METHODS: This study conducted a retrospective analysis of 38 patients who underwent conjunctival flap coverage followed by prosthetic eyepiece fitting after developing ocular atrophy secondary to FCVB surgery. Anterior corneal elastic sublaminectomy combined with conjunctival coverage was performed on the FCVB-implanted atrophic eyes. Prosthetic lenses were fitted after complete healing of the stroma and conjunctiva and suture removal. Corneal irritation, eyeball protrusion, axial length, lid height, cosmetic satisfaction, and pain numerical rating scale scores were observed before the conjunctival flap covering and after the prosthetic eyepiece surgery. RESULTS: The ocular protrusion was 11 mm preoperatively and 14 mm postoperatively, with the difference being statistically significant (Z=-5.459, P<0.001). The ocular axis length was 20.82±0.94 mm in the experimental group and 23.57±0.33 mm in the control group, showing a statistically significant difference (t=-20.207, P<0.05). The lid height was 6 mm in the experimental group and 9 mm in the control group, a difference that was statistically significant (Z=-5.326, P<0.001). The appearance satisfaction score was 1 in the experimental group and 4 in the control group, with this difference being statistically significant (Z=-5.447, P=0.001). Regarding the pain numerical rating scale score, the ranges were 0-2 in the experimental group and 0 in the control group. No discomfort was reported after wearing the prosthetic eyepiece, and the difference was not statistically significant (Z=-1.100, P>0.05). There was no statistically significant difference between pre- and post-treatment satisfaction. CONCLUSION: A conjunctival flap covering and a prosthetic eyepiece after FCVB postoperative atrophy can reduce the number of surgeries, alleviate patients’ economic burdens, satisfy patients’ psychological eyeball retention requirements, and provide better cosmetic efficacies for patients desiring eyeball retention or silicone-oil dependence.