Purpose The aim of the present study was to report the improvement in unaided visual acuity in nonprogressive keratoconus cases previously treated with intrastromal corneal ring segment implants (Intacs) after topography-guided photorefractive keratectomy (PRK) and corneal collagen cross-linking (CXL). Patients and methods Twelve eyes of 12 patients, previously treated with Intacs for the treatment of keratoconus, with residual refractive error and nonprogressive keratoconus, were selected for partial or complete refractive error correction by using PRK, followed by CXL in the same sitting. All cases were followed up for 1 year. Results All eyes included in the study showed stable improvement in the unaided and aided visual acuity 1 year after PRK and CXL. Conclusion PRK with CXL can be used to enhance aided and unaided visual acuity after treatment of keratoconus with Intacs implants, with a stable refractive outcome, and could postpone penetrating or lamellar keratoplasty in patients with the visually disabling disease of moderate keratoconus.