https://bugs.winehq.org/show_bug.cgi?id=48726
--- Comment #2 from RĂ©mi Bernon rbernon@codeweavers.com --- Thanks for the bug report, would you mind telling what mouse model you are using? And if you know what its polling rate is?
I believe this could be caused by a high polling rate mouse, which can trigger a higher load on the wineserver and the game process with the patch, and possibly increase the frame time, making it miss the vsync.
Maybe disabling vsync could help, if that's possible somehow (I don't know what this shader thing does, maybe it forces vsync on).