AIM: To investigate the effects of tobramycin dexamethasone eye drops combined with diclofenac sodium eye drops on postoperative inflammatory markers and recurrence in patients with pterygium.METHODS: A retrospective study was conducted to collect the relevant data of 102 patients(102 eyes)with pterygium who were treated with tobramycin dexamethasone eye drops after pterygium excision and conjunctival transposition of autologous limbal epithelium from May 2021 to May 2024. They were divided into two groups according to different medication, including 51 eyes treated with tobramycin dexamethasone eye drops in control group and 51 eyes treated with tobramycin dexamethasone eye drops and diclofenac sodium eye drops in observation group, and both groups were treated for 4 wk. Followed-up for 6 mo, the levels of inflammatory factors at each time point, ocular symptom scores, lacrimal gland function, adverse reactions during the medication, and disease recurrence were compared.RESULTS: The time required for conjunctival flap congestion and corneal wound epithelial regression in the observation group was shorter than that in the control group(all P<0.001). At 1, 2, and 4 wk after surgery, the levels of interleukin-6(IL-6), IL-1β, and tumor necrosis factor-α(TNF-α)in both groups decreased compared to the day of surgery, and the levels of each indicator in the observation group were lower than those in the control group at all time points(all P<0.05). At 1 wk after surgery, the time for the first tear film rupture in both groups was shortened compared to before surgery(P<0.05), while there was no statistical significant difference in the Schirmer I test(SⅠt)between the two groups compared to before surgery(P>0.05). At 2 and 4 wk after surgery, the time of first tear film rupture and the SⅠt in both groups increased compared to before and 1 wk after surgery, and the observation group was better than the control group(all P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups of patients during medication(7.8% vs 3.9%, P>0.05). After a 6-month follow-up, the recurrence rate in the observation group was lower than that in the control group, but the difference was not statistically significant(3.9% vs 17.7%, P=0.051).CONCLUSION: The combination of tobramycin dexamethasone eye drops and diclofenac sodium eye drops for postoperative treatment of pterygium patients is more effective than using tobramycin dexamethasone eye drops alone. It is beneficial for alleviating postoperative inflammatory reactions, improving patient comfort, promoting postoperative lacrimal gland function recovery, reducing recurrence, and has higher safety.