Objective: To explore the effect of keratoplasty on the control of the ocular axis in children and adolescents with myopia. Methods: Seventy-five cases of children and adolescents who underwent myopia correction at a hospital between September 2023 and August 2024 were selected. Participants were divided into a control group (37 cases, wearing eyeglasses) and an observation group (38 cases, wearing keratoplasty lenses) using the random number method. Visual function, naked-eye visual acuity, ocular axis length, and refractive error were compared and analyzed between the two groups before and one year after the correction treatment. Results: Before correction, there were no statistically significant differences in the amplitude and sensitivity of accommodation between the two groups (P > 0.05). After correction, all indices increased significantly in both groups, with the observation group showing higher values than the control group (P < 0.05). Similarly, prior to correction, there were no significant differences in naked-eye visual acuity, axial length, or refractive error between the two groups (P > 0.05). After correction, all indices improved significantly in both groups; however, the observation group demonstrated superior results compared to the control group, with statistically significant differences (P < 0.05). Specifically, the naked-eye visual acuity in the observation group was higher, refractive error was lower, and ocular axis length was shorter than in the control group, all with statistical significance (P < 0.05). Conclusion: Keratoplasty effectively controls the ocular axis in children and adolescents with myopia. It not only enhances visual function but also significantly improves naked-eye visual acuity, reduces refractive error, and shortens the length of the ocular axis.