This intraoperative image from a full-thickness keratoplasty procedure depicts a donor graft being placed over the recipient bed using a shovel. The ledges are fashioned using Vanna's scissor after an adequate-diameter trepination has been performed. It is crucial to put four cardinal sutures at the earliest possible time at this step so that the risk of suprachoroidal hemorrhage is minimized. Also, the sharp cutting edge of manual trephine had been marked with blue surgical marker so as to clearly delineate the edges of the recipient bed.