Abstract:  The fundamental pathophysiological mechanism of malignant glaucoma is the posterior misdirection of aqueous humor into the vitreous, which results in the forward displacement of the lens-iris diaphragm and the shallowing of the entire anterior chamber, with or without elevated intraocular pressure. The promotion and dissemination of the irido-zonulo-hyaloid-vitrectomy (IZHV) procedure, which is considered the gold standard for treating malignant glaucoma in clinical practice, have led to a deeper understanding of the role played by the structural and functional abnormalities of the ciliary body-zonules-crystalline lens-hyaloid-anterior vitreous complex (CZLHV) in the occurrence and progression of malignant glaucoma. In this review, we aim to elaborate the pathogenesis of malignant glaucoma from the view of this complex concept, and subsequently propose the modified management strategy that follows our understanding of the complex and significantly improve visual prognosis of patients with malignant glaucoma.  (Ophthalmol CHN, 2024, 33: 161-168)

Key words:  malignant glaucoma/surgery, malignant glaucoma/pathogenesis, ciliary body-zonules- crystalline lens-hyaloid-anterior vitreous complex