AIM: To observe the changes of relative peripheral refraction(RPR)after wearing orthokeratology(OK)lens, and to explore the relationship between the changes of RPR and the axial length(AL).METHODS: Totally 104 cases of adolescent myopia(-1.00D to -6.00D)were selected from May 2016 to Nov. 2018. Then they were randomly divided into the experimental group and the control group. The experimental group wore OK lens, and the control group wore frame glasses. Their AL, RPR(N30°-T30°)were observed for 1a.RESULTS:The RPR of the experimental group showed myopic drift at each time point after wearing OK lens(P<0.05), and the change was most obvious in 1mo(P<0.05). After 1mo, the RPR basically tended to be stable(P>0.05). The RPR of the control group showed an increase in hyperopia. One year later, there were statistical differences in the changes of AL and RPR between the two groups(P<0.001). There was a positive correlation between the changes of AL and RPR in the experimental group(P<0.001).CONCLUSION: After wearing OK lens, the AL growth slowed down, while the RPR showed myopic drift and it was most obvious in 1mo. There was a correlation between the changes of AL and RPR.