Objective To analyze the effect of orthokeratology lens on myopic refractive diopter and optic axis in children with low corneal curvature myopia. Methods A total of 104 children with low corneal curvature myopia admitted to Beijing Meiermu Eye Hospital from January 2022 to January 2024 were selected as the research subjects. According to the random number table method, they were divided into the control group and the study group, with 52 children in each group. The control group wore frame glasses, and the study group wore orthokeratology lenses. The myopic refractive diopter and optic axis changes, corneal thickness, endothelial cell changes and ocular complications were compared between the two groups. Results After 6 months of wearing, the myopia diopter and the growth degree of the optic axis in the study group were both smaller than those in the control group (P <0.05). After 6 months of wearing, there were no significant differences in the endothelial cell indexes between the children with low myopia and moderate myopia in the study group and those in the control group (P >0.05). After 6 months of wearing, there were no significant differences in the corneal thickness between the children with low myopia and moderate myopia in the study group and those in the control group (P >0.05). The rate of ocular complications in the study group was 5.77%, compared with 3.85% in the control group, the difference was not statistically significant (P >0.05). Conclusion The application of orthokeratology lenses in the treatment of children with low corneal curvature myopia has a good control effect on the myopia diopter and the growth of the optic axis, and it will not affect the corneal thickness and endothelial cells, with high safety. It is worthy of application.