In patients with treated endophthalmitis secondary to a bleb leak, how do you determine timing of revision?

There are really two separate (but related) issues to address here:

1. The infection. This is treated in conjunction with my vitreoretinal colleagues, as it will require intravitreal antibiotics +/- vitrectomy, depending on the degree of posterior segment involvement. Of course, the bleb is also cultured, and broad-spectrum topical fortified antibiotics followed by targeted therapy when cultures are available are also a critical part of the process.
2. The bleb leak. Even if the leak "seals" with treatment of the infection, this is surely just a temporary condition. The necrotic/ischemic bleb tissue must be removed, with subsequent mobilization of healthy conjunctiva to cover the scleral flap. A patch graft may be necessary, depending on the ext...