Keratoconus is an ectatic disorder that manifests itself around puberty. Despite the different ways of management of keratoconus, its management is a continuous field of research. The aim of this study was assessment of the efficacy of the Intrastromal corneal ring segments (ICRS) insertion in Steep Versus Flat axis for treatment of keratoconus. The study is a prospective, non-randomized, interventional clinical study, included a total of 30 eyes of 24 patients. We insert ICRS In two different site of cornea in the steep meridian vs. flat meridian and follow-up 1w,3m and 6 m. after surgery. this technique is statistically significant decreasing myopia, corneal steepness, and decentration of the of the corneal apex. The technique appears to be safe and is also potentially reversible. The corneal intrastromal implantation system provides a new option for keratoconus management.