Keratoconus is a progressive non-inflammatory corneal disease, followed by corneal thinning and protrusion. Keratoconus progression can cause vision problems by inducing irregular astigmatism, myopia, and corneal scars \cite{Auffarth_2000}. So far, various treatment choices for keratoconus management are assessed based on the severity of the condition. These clinical options are introduced to improve patient visual acuity and prevent disease progression by stabilizing the corneal structure. The approaches are varied, ranging from cross linking, intracorneal rings (ICRs) implantation, and lamellar keratoplasty \cite{Vega_Estrada_2012,Vega_Estrada_2013,Watson_2004}.

Clinical studies have shown that ICRs implantation is an effective and safe method to improve visual acuity and controlling disease progression \cite{d_Azy_2019}. ICRs are designed to be implanted within the corneal stroma aiming to reduce geometry steepening by inducing an arc-shortening effect. MyoRing (DIOPTEX) and Keraring (Mediphacos) are two examples of complete continuous and non continues ICRs, which are inserted into stroma via induced pocket and tunnel, respectively \cite{Le_n_2012, Daxer_2010}. In clinical practice, ICRs type selection mainly depends on the keratoconus stage, topographic pattern, and surgical nomograms \cite{Yousif_2018}. Nevertheless, despite the presence of practical nomograms that provide suitable platforms for ICRs selection in different case scenarios, there are still complications associated with postoperative outcomes \cite{ Oatts_2017}.

ICRs immigrant, corneal melting, and ICRs extrusion are among the post-surgery common complications. From a mechanical perspective, ICRs extrusion is associated with locally induced tensions at the implant insertion site, which can be followed by later corneal melting and vascularization \cite{Mounir_2020}. In postoperative ring extrusion, the corneal progressively becomebecomes weak, leading to biomechanical instability and tissue failure. Hence, a proper evaluation of biomechanical alternations induced by different ICRs types on keratoconus tissue can optimize and improve surgery safety and efficiency. Apart from that, the main percentage of the unexpected postoperative results are associated with the patient primary keratoconus stage and pattern. Thus, the contribution of the corneal preoperative geometrical and biomechanical state to postoperative outcomes should be considered.