Purpose <p>This research was focused on evaluating the safety and efficacy of orthokeratology (Ortho-K) lenses in the management of myopic regression for patients who had previously undergone LASIK surgery.</p> Methods <p>In this retrospective, randomized study included 14 Chinese patients (26 eyes) who had undergone LASIK surgery more than 10 years prior and subsequently experienced myopic regression. Over a 30-month period of Ortho-K lens wear, changes in the Bowman’s roughness index, corneal and corneal flap thickness were evaluated using optical coherence tomography (OCT). The main goal of the research was to evaluate was to assess the impact of Ortho-K lens use on these parameters in individuals who have undergone LASIK surgery in the past surgery and myopic regression.</p> Result <p>Prior to fitting the Ortho-K lenses, the average thickness of the central cornea was measured to be 481 ± 24&#xa0;μm, whereas the thickness of the central corneal flap was found to be 181 ± 18&#xa0;μm. Additionally, the nasal and temporal corneal flap thicknesses were measured as 145 ± 17&#xa0;μm and 146 ± 21&#xa0;μm, respectively. Following a period of Ortho-K lens wear, significant flattening was observed in both the central corneal thickness (461 ± 14&#xa0;μm, <i>p</i> &lt; 0.05) and central corneal flap thickness (162 ± 26&#xa0;μm, <i>p</i> &lt; 0.05). Conversely, the nasal and temporal corneal flap thicknesses increased significantly to 164 ± 27&#xa0;μm (<i>p</i> &lt; 0.05) and 169 ± 23&#xa0;μm (<i>p</i> &lt; 0.05), respectively. The pre-fitted Bowman’s roughness index (BRI) was recorded as 2.367 × 10^− 3 mm². Despite changes observed during the follow-up period, the final BRI measurement remained stable at 2.397 × 10^− 3 mm² (<i>p</i> = 0.687), indicating no significant alteration.</p> Conclusion <p>This work demonstrated the ability to treat myopic progression after LASIK safely and effectively with overnight ortho-K.</p>