Objective To determine the feasibility and efficacy of rigid gas permeable contact lenses (RGPCL) with reverse geometry design (RGDRGPCL) for correction of ametropia after laser in situ keratomileusis (LASIK), photorefractive keratectomy (PRK) and radial keratectomy (RK) surgery. Methods The changes in corneal topography were compared between patients after corneal refractive surgery and after being fitted with Ortho-K CLs for myopia. Twenty-nine patients (51 eyes) who had poor visual acuity and significant residual ametropia after corneal refractive surgery were selected to wear RGDRGPCL. The CL fitting, corrected visual acuity, patient satisfaction, changes in corneal shape, wavefront aberrations and ocular surface health were evaluated. The refractive status of 50 eyes after surgery were as follows: -1.00 to -18.75 DS and 0.75 to 4.50 DC. Unaided visual acuity was 3.0 to 4.8. One aphakic eye with post-RK and post-traumatic surgery was +8.00 D/+6.00 D×10°, Unaided visual acuity was 3.0. All patients whose visual acuity was corrected with spectacles were not satisfied or were anisometropic. Results Tomey Ⅳ corneal topography showed 30 placido rings, and the mean curvature of 6 rings (5 zones) was calculated. It showed that the parameters of each zone after surgery and Ortho-K CL wear had comparatively close values [(39.24±2.09)D vs (39.27±1.23)D;(39.24±2.46)D vs (39.88±1.19)D;(40.34±2.48)D vs (41.39±1.43)D;(41.23±2.43)vs (41.21±1.45)D;(41.02±2.36) vs (40.50±0.79)D], and the differences in each zone between the two groups were not statistically significant (P>0.05). When wearing RGDRGPCL, visual acuity achieved 5.0 or better in 35 eyes, and the fitting was good. All patients were satisfied with the clarity and comfort. Wavefront aberrations decreased significantly in some patients. There were no remarkable complications on the ocular surface. Some patients showed regular corneal reshaping after long-term RGDRGPCL wear. Conclusion In cases of lower visual acuity after corneal refractive surgery, which is difficul