I think the only differences might be how insanely handles anchor links and video links.
I played with it a bit to get it to go the specific links I mean when I type in long queries. (clicking a video link if available up there, clicking an anchor link if available and emphasized with "jump to".)
http://cenix.co.uk/im-feeling-lucky-google-chrome-shortcut/
I have it as a keyword "lucky" (type lucky and press tab to use it), but you can just as easily make it the default search.