Background: Life expectancy of the population may increase and cataract development may affect all the people with aging. Intraocular lens implantation surgery, a worldwide performed procedure, evolves and progresses. However, different techniques exist, which could be selected for different cases. Any ideal technique should be safe, simple, fast, and easy to learn with good clinical outcome. Objective: The aim of this work was to compare the efficacy and safety of intraocular lens implantation with and without ophthalmic viscoelastic device after phacoemulsification as well as surgery duration and post-operative intraocular pressure and central corneal thickness. Patients and methods: This was a prospective, randomized controlled trial conducted on 40 eyes with cataract; to compare the efficacy and safety of intraocular lens implantation with and without ophthalmic viscoelastic device after phacoemulsification of the lens as regard to surgery duration, post-operative intraocular pressure and central corneal thickness. Patients were evaluated 1 day, 1 week, and 1 month postoperatively. Patients were divided into two groups after the completion of lens cortex removal:  Group A (n=20, hydro-implantation): One-piece acrylic intraocular lens implantation was performed with normal saline solution (0.9 solution) irrigation.  Group B (n=20, visco-implantation): using Hydroxy-propyl-methyl-cellulose 2% implantation. Results: Highly significant increase in phaco operative time in visco-implantation group; compared to hydro-implantation group (p < 0.0001), Non-Significant increase in post-operative IOP, in visco-implantation group; compared to hydro-implantation group (p > 0.05 respectively). Non-significant difference as regards post-operative Central corneal thickness (CCT) (p > 0.05). Non-significant increase in post-operative CCT measurements in visco-implantation group (p > 0.05). Non-significant difference in post-operative IOP measurements in visco-implantation group (p > 0.05). Non-significant decrease in post-operative IOP and CCT measurements in hydro-implantation group (p > 0.05). Non-significant decrease in post-operative IOP in hydro-implantation group; compared to visco-implantation group; during the serial 1st and 2nd measurements. Non-significant increase in post-operative CCT in Visco-implantation group; compared to hydro-implantation group; during the serial 1st and 2nd measurements. Conclusion: The hydro-implantation had similar clinical outcome to visco-implantation with advantage of reduced surgical time and cost, and no ophthalmic viscosurgical devices (OVD) induced intraocular pressure elevation postoperatively.