Our research has shown the following factors for increased recurrence risk.
1. Total amount of UV exposure (well known)
2. History of smoking
3. History of family members with pterygium
4. Male gender
5. Temporal pterygium
There is some data to suggest patients with Demodex have a potentially higher risk as well.
Thus consider using tea tree oil (have post about that) to treat demodex prior to surgery and keep lids clear from bacteria, debris with lid hygiene technique (have post about that also) to give your eye best chance of pterygium not recurring.
If you see pterygium recurring there are things you can do to try to prevent it:
1. Prevention always: hat, sunglasses (preferably wrap around ones…ugh.. but work)!
2. Cold artificial tears to constrict blood vessels 4x/d
3. Tell eyeMD: who might consider AVASTIN (anti-angiogenic drug) injection to stop pterygium from growing more or steroid injection (but has more risks than Avastin.
4. Early removal to help decrease amount of conjunctiva that needs to be removed from donor site also (CAG: conjunctival autograft).
5. Treat with diluted tea tree oil: studies are still pending, but I would do this if I had a recurrent pterygium as it does not really hurt and cost is low and potential benefit is present.