AIM:To evaluate the early stage of fresh amniotic membrane transplantation for treatment of severe ocular alkali burn. METHODS:Forty-eight cases of 67 eyes with severe alkali burns were divided into A,B groups according to visiting time,26 cases of 38 eyes burned for 0.5 hours -7 days (including 7 days) were treated for the A group; 22 cases of 29 eyes burned for 7-20 days (not including 7 days) were treated for the B group,both groups were transplanted with fresh amniotic membrane and wore soft contact lenses after operation. The ocular surface conditions and visual acuity were observated after 3 months. RESULTS:There were 28 eyes of full transparent cornea,5 eyes of semi-transparent,3 eyes of all muddy and 2 eyes of corneal leukoplakia,and 2 eyes of symblepharon,and 2 eyes of new blood vessels,and the visual acuity of 28 eyes was ≥0.4,10 eyes <0.4 in A group. There were 12 eyes of full transparent cornea,7 eyes of semi-transparent,6 eyes of all muddy and 4 eyes of corneal leukoplakia,and 7 eyes of symblepharon,and 15 eyes of new blood vessels,and the visual acuity of 11 eyes was ≥0.4,18 eyes <0.4 in B group. Comparison of the two groups were statistically significant (P<0.05).CONCLUSION:Early fresh amniotic membrane transplantation could be better for reconstruction of ocular surface and improving vision,it is the best therapeutic approach for the severe ocular alkali burns. 