〔Abstract〕 Objective To analyze the effect of different incision choices on tear film function and surgical safety in the treatment of strabismus patients. Methods A total of 60 patients with strabismus who underwent surgery in Sanming First Hospital Affiliated to Fujian Medical University from January 2018 to January 2022 were selected and divided into two groups according to different incision choices. 28 patients were treated with limbal trapezoidal conjunctival flap incision as the control group, and 32 patients were treated with modified Parks incision as the observation group. The overall operation effect was compared between the two groups. Results The dry eye symptom score, tear secretion and tear film rupture time at 7 and 14 days after operation in the two groups were lower than those before operation, and the dry eye score in the observation group was lower than that in the control group, and the differences were statistically significant (P < 0.05). The incidence of complications in the observation group was 3.13 % (1/32), which was lower than 25.00 % (7/28) in the control group, and the difference was statistically significant (P < 0.05). The operation satisfaction of the observation group was higher than that of the control group, and the difference was statistically significant (P < 0.05). Conclusion Different incisions can ensure the therapeutic effect of strabismus surgery, but modified Parks incision can promote the improvement of tear film function and improve surgical safety.