Purpose: To investigate the changes in the optical corneal densitometry as an objective method in assessing the corneal light back-scattering before and 1 year after the annular intracorneal INLAY (AICI) implantation into the keratoconic corneas. Methods: Changes in the optical corneal densitometry, visual acuity, refractive, and tomographical status were assessed before and 1 year after the AICI implantation into the corneas with different stages of keratoconus. Optical corneal densitometry was evaluated using the Pentacam‑ HR in 0– 2, 2– 6, 6– 10, and 10– 12 mm rings in the anterior 120 µ , central layers, posterior 60 µ and also the total value were measured for cornea in the Grey Scale Unit criterion. Results: Totally, 34 patients with keratoconus were studied; the uncorrected and best corrected visual acuity were increased after the surgery (0. 98 ± 0. 25 to 0. 53 ± 0. 30 logMAR, P < 0. 001 and 0. 26 ± 0. 18 to 0. 19 ± 0. 14, P = 0. 007 logMAR, respectively); the spherical equivalent was decreased from − 4. 45 ± 2. 25 to − 2. 06 ± 2. 01 D (P = 0. 004). AICI implantation led to an increase in the amount of optical corneal densitometry in 0– 2 mm central, 2– 6 mm central, 6– 10 mm central, total central, 2– 6 mm posterior, and 2– 6 mm total rings (all, P < 0. 05); however, a decrease was observed in 0– 2 mm anterior ring (P = 0. 049). Results of statistical analysis showed that the total optical corneal densitometry, anterior total, and posterior total back-scattering did not change after the AICI implantation (all, P > 0. 05). Conclusions: Our results revealed a significant improvement in the visual function, including refractive error and visual acuity following the AICI implantation. Changes in the optical corneal densitometry were different in distinct regions and layers however, the total amount did not change after the AICI implantation.