近视作为全球高发疾病，严重影响我国青少年的眼部健康。角膜塑形镜是一种能有效控制近视增长速度的硬性角膜接触镜，但其作用机制尚未完全探明。而高阶像差作为影响视觉质量的因素之一，在角膜塑形术后会发生显著变化，其中以球面像差(球差)、彗形像差(彗差)较为关键。角膜塑形镜使角膜形态发生改变后，导致球差和彗差显著正向增加，球差和彗差的增加量与角膜塑形术后眼轴增长的速度呈显著负相关。球差与离焦和调节、彗差与散光和伪调节等存在的相互作用可能是其在角膜塑形镜控制近视中发挥作用的机制。

As a highly prevalent global condition, myopia significantly impacts the ocular health of young individuals in China. Orthokeratology lens, as a rigid corneal contact lens, has demonstrated effective control over the progression of myopia; however, its mechanism of action remains incompletely elucidated. As one of the factors influencing visual acuity, higher-order aberrations will undergo marked changes after orthokeratology, with particular emphasis on the alterations in spherical aberrations and coma. The changes in corneal morphology induced by orthokeratology lead to significant positive increase in both spherical aberration and coma. Furthermore, the elevation of spherical aberration and coma demonstrates a negative correlation with the rate of axial length growth following orthokeratology. The interplay among spherical aberration, coma, defocus, accommodation, astigmatism, and pseudo-accommodation may constitute the underlying mechanism governing the control of myopia through orthokeratology.