惡性青光眼是一種發生於隅角閉鎖性青光眼患者接受眼內手術後罕見的併發症，開刀時房水排出系統完全閉鎖的眼睛及軸性遠視眼有較高的危險性。對眼科醫師而言，惡性青光眼一直是臨床上困難的挑戰，這極可能是因為它的致病機轉尚未被釐清。初始的診斷下得慢，就延後了投予藥物的內科治療。不僅藥物治療對大部分的患眼沒有效果，外科手術治療又是困難且富爭議性的。在這裡我們藉由報告一個典型病例，闡明在處理惡性青光眼時，會遇到的一些特點及問題。在現代微創手術的幫助下，惡性青光眼可以被反轉，並能維持良好的視力和眼壓。

Malignant glaucoma is one of the most serious complications of intraocular surgery, which in the natural course results in loss of vision in a short peroid of time. Closure of the drainage angle at the time of surgery and axial hypermetropia is related to increased risks. Despite established common risk factors, malignant glaucoma continues to present a rare condition with challenging management, which might perhaps be the fact that the exact mechanism behind its etiology is not yet understood. Diagnosis may be delayed right at the beginning, resulting in a delay in administering optimal medical therapy. Response to medical therapy may not be significant in many eyes and surgical management remains difficult and controversial. Through this case we reported, some of the important features and problems that may be encountered during the management of malignant glaucoma will be shown. We performed pars plana vitrectomy, phacoemulsification and secondarily intraocular lens implantation, without a patent communication between the posterior and the anterior chambers. In the light of modern microsurgical techniques, reversal of malignant glaucoma can be attained with preservation of good visual acuity and intraocular pressure (IOP) control.