AIM: To analyze the risk factors for recurrence after pterygium excision and the influence on corneal astigmatism and tear film break-up time.METHODS:Retrospective study. A total of 110 pterygium patients(110 eyes)admitted to our hospital from January 2020 to January 2023 were selected, including 77 primary pterygium patients(77 eyes)and 33 recurrent pterygium patients(33 eyes). Pterygium excision was performed in all patients. The corneal astigmatism and tear film break-up time of patients with pterygium were measured before and after operation. The recurrence of pterygium was analyzed and the risk factors of recurrence were analyzed.RESULTS:In this study, 8 eyes with pterygium recurred after excision, and the recurrence rate was 7.3%. There was no difference in corneal astigmatism of all patients before and after surgery(2.02±0.32 vs 2.00±0.32 D, P>0.05), and there was a difference in tear film break-up time(9.55±1.24 vs 13.46±2.56 s, P<0.05). The results of multi-factor Logistics regression analysis showed that age, working environment, diabetes, pterygium nature, postoperative tear film break-up time and operation method were the factors that affected the recurrence of pterygium after excision(all P<0.05).CONCLUSION:Age, working environment, diabetes mellitus, pterygium nature, postoperative tear film break-up time and surgical method are all risk factors for postoperative recurrence of pterygium.