AIM: To evaluate the clinical effect and complications of two different filling materials (aerocyst urethral catheter and expansion sponges) applying in external dacryocystorhin- ostomy (EXT-DCR) and compare their advantages and disadvantages. METHODS: A retrospective study was made in the period from April, 1 2000 to April, 1 2005. Totally 180 patients (240 eyes) underwent the EX-DCR using different filling materials and divided into three groups randomly: negative control groups (group 1), expansion sponges group (group 2) and aerocyst urethral catheter group (group 3). The gender, etiology, clinical findings, surgical technique, filling materials, the condition of ocular surface and complications were analyzed. Filling materials were removed during day 7. Postoperative success was determined by lacrimal patency to irrigation, a positive dye test, hemorrhage and errhysis conditions after extubation and subjective resolution of epiphora and liquor puris. RESULTS: During a mean follow-up of 5.14±1.69 years, the success rate were 73.7％ (group 1), 86.5％(group 2), 98.7％ (group 3) in three groups. There was significant statistical difference among three groups in the surgical success rate and the operative complications (including hemorrhage, errhysis, periorbital ecchymosis after extubation)(P<0.05). CONCLUSION: EXT-DCR with aerocyst urethral cathete intraoperatively have higher success rate，fewer operative complications and a high patient satisfaction ,and can be used to simplify and speed up traditional EXT-DCR.