In conclusion, our study revealed that the pathogenesis of keratoconus may be due at least in part to ferroptosis on the ocular surface, and the core gene AKR1C3 was identified by bioinformatics analysis, showed a connection to the expression of miR-184 and other miRNAs, as well as the over expression of inflammatory factors and immune subtype cells. This evidence concerns the gene AKR1C3 and keratoconus.