Cataract surgery has evolved over the years with the development of intraocular lenses (IOL), leading to improvement in visual outcome after surgery. Posterior capsular opacification (PCO) is a common complication after cataract surgery and the material of the IOLs is a determinant for developing this complication. Therefore, it is crucial to understudy ways to reduce the risk of this complication. Additionally, it is essential to consider the contrast sensitivity, visual acuity (V.A), and glare formation for these lenses. This study intends to do a systematic review of randomized controlled trials (RCT) that evaluated the difference in the PCO rate and visual performance between patients that had either hydrophilic or hydrophobic IOLs and followed up for at most three years. A comprehensive search was conducted on PubMed, Google Scholar, and Embase. Randomized control trial papers published in the last eighteen years were analyzed. 397 studies were found. Only 15 articles were included in the review after screening, removal of duplicated articles, and evaluation of eligibility criteria. Hydrophobic IOL is associated with less PCO than hydrophilic IOL. However, the visual performance with regard to V.A, glare formation, and contrast sensitivity were comparable for both lenses. A notable limitation of this review was the small sample size of most of the studies. Therefore, more prospective and randomized trials with larger sample sizes are required in this area.