Keratoconus (KC) is a bilateral asymmetric progressive corneal degenerative disease associated with corneal thinning and protrusion. The management of moderate progressive keratoconus involves halting its progression through corneal cross-linking as well as flattening of the ectatic steep cornea through the implantation of intrastromal corneal rings (ICR). Different nomograms were used to guide ophthalmic surgeons for the proper choice of ICR implantation to achieve the best results. The aim of the current study is to assess the visual, refractive and tomographic outcomes of Keraring implantation based on the Alfonso nomogram, in patients with keratoconus.