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Although the nonsurgical treatment for idiopathic intracranial hypertension (IIH) involves weight loss, diuretics, and steroids, surgical intervention is required if there is a worsening of symptoms or visual deterioration. To determine the efficacy and complications of transcranial optic nerve sheath fenestration (ONSF) using an ultrasonic aspirator as an adjunct in the treatment of refractory IIH. This prospective study included all patients with medically refractory IIH with visual deterioration from November 2017 to June 2019. Pteri