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Corneal biomechanical parameters and most ocular biometry were measured at baseline, 1\u2009week, and at 1, 3, 6, 12, 18 and 24\u2009months. Axial length (AL) was collected every 6\u2009months after baseline measurements.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During the 2\u2010year follow up, nine corneal biomechanical parameters, including deformation amplitude maximum (DA), varied between baseline and 1\u2009week (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) and stabilized during the rest of wearing period (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05). The mean AL increased from 25.02\u2009\u00b1\u20090.84\u2009mm to 25.38\u2009\u00b1\u20090.81\u2009mm and baseline DA strongly correlated with AL progression (Pearson <jats:italic>r<\/jats:italic>\u00a0=\u00a00.37). In the multiple regression models, baseline age, AL and DA were the independent factors for AL progression (<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>: 0.7849, 0.2180 in low and moderate myopes). The area under the receiver operating characteristic curves using the three variables for predicting excessive AL progression (&gt;0.35\u2009mm during 2\u2009years) in low and moderate myopes was 0.902 and 0.698.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Corneal biomechanics firstly fluctuated before becoming stable with long\u2010term ortho\u2010k use. Corneal biomechanics was associated with AL progression in children wearing ortho\u2010k lenses. DA combined with age and AL at baseline could predict AL progression in low myopes using ortho\u2010k.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aos.15662","type":"journal-article","created":{"date-parts":[[2023,3,24]],"date-time":"2023-03-24T04:24:06Z","timestamp":1679631846000},"page":"755-765","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Changes of corneal biomechanics in children using orthokeratology and their roles in predicting axial length progression\u2014A prospective 2\u2010year study"],"prefix":"10.1111","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0004-8920","authenticated-orcid":false,"given":"Kaidi","family":"Xiang","sequence":"first","affiliation":[{"name":"Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital Shanghai Vision Health Center &amp; Shanghai Children Myopia Institute  Shanghai China"},{"name":"Department of Ophthalmology, Shanghai General 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Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine Shanghai Jiao Tong University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9897-1192","authenticated-orcid":false,"given":"Zhuoting","family":"Zhu","sequence":"additional","affiliation":[{"name":"Ophthalmology, Centre for Eye Research Australia University of Melbourne  Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Ding","sequence":"additional","affiliation":[{"name":"Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital Shanghai Vision Health Center &amp; Shanghai Children Myopia Institute  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriella","family":"Bulloch","sequence":"additional","affiliation":[{"name":"Ophthalmology, Centre for Eye Research 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