Posterior capsule opaci?cation (PCO) is a common complication following cataract surgery with posterior chamber intraocular lens (PCIOL) implantation. This study aims to compare the development of PCO between hydrophilic and hydrophobic acrylic PCIOLs.Methods: An observational study was conducted over 12 months, involving patients with age-related cataract who underwent cataract surgery at KJ SOMAIYA Hospital. The patients were divided into two groups based on the type of PCIOL used: hydrophilic (Group I) and hydrophobic (Group II). PCO analysis was performed at one, three, and six months using retroilluminated images captured with slit lamp-guided anterior segment photography.Results: Among the 160 eyes included in the study, PCO grade 2 was the most common in both groups (56.25% in Group I and 66.25% in Group II). PCO grade 3 was observed in 35% of eyes in Group I and 17.5% of eyes in Group II, indicating a 2.7-fold higher incidence in Group I. PCO grade 3 was more prevalent in younger patients, individuals with diabetes, and patients with immature cataracts.Conclusion: The incidence of PCO is higher with hydrophilic IOLs compared to hydrophobic IOLs. However, this increased incidence is also associated with younger patient age, diabetes mellitus, and immature cataract grade, which are known risk factors for PCO.