Abstract: Malignant glaucoma is one of the most severe complications of glaucoma surgery. It mainly includes three types: typical malignant glaucoma, malignant glaucoma after cataract surgery, and other secondary malignant glaucoma. Anatomical factors such as a shallow anterior chamber, short axial length, and thick lens, as well as being young, female, diagnosed with angle-closure glaucoma, having a history of external filtration surgery, and preoperative high intraocular pressure, are considered risk factors for the occurrence of malignant glaucoma. The hypothesis of trans-lens pressure differential provides a new perspective for rethinking and understanding the pathogenesis of malignant glaucoma, and may offer new strategies for its prevention and treatment. Relieving ciliary block and restoring the flow of aqueous humor between the anterior and posterior chambers of the eye are key in the treatment of malignant glaucoma.  (Int Rev Ophthalmol, 2024, 48: 321-326)

Key words: malignant glaucoma, trans-lens pressure differential, ciliary block