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To study the mechanism underlying malignant glaucoma examined by ultrasound biomicroscopy (UBM) combined with axial scan and to observe the course of cilio-lens block in living eyes in real time, when malignant glaucoma occurs and remises, two cases of malignant glaucoma are reviewed. The two cases have common characteristics, such as short axial length, pseudophakia, and patent peripheral iridotomy. Both cases eventually achieved intraocular pressure control without surgical intervention during their management courses. UBM and axial scan were used for early detection, to confirm the diagnosis of these cases, and to observe the course of treatment. This method allows patients at risk for the disease to be identified and successfully treated before irreversible damage to the nerve occurs. These cases accentuate the importance of cycloplegic drugs in long-term malignant glaucoma treatments.