I often have seal problems with IEMs (lack of bass is the main symptom), but not so much with the IEM staying in place (secure fit), and isolation is not a main concern for me.
The tips included with every IEM rarely work for me!
Foam tips (Comply) work for me as well. However, in order to compress them enough so the IEM stays in place, I need to be able to insert them deep enough. So, the nozzle (more common term than "barrel" I believe) diameter may be an important parameter (by the way, some nozzles are oval in shape), but the nozzle length relative to the IEM main body is at a minimum as important: IEMs with a very short nozzle such as the classic Blon BL3, just don't fit securely with foam tips for me.
On the other hand, I don't think the nozzle size is very critical when you use silicon tips, as long as you can install the tips onto the nozzle and they don't slip away.
Large size (L or XL) Spinfit tips work very well for me (good seal), but the seal is done in a different area of my ear canal, not as deep as with foam type. Although I am always concerned getting a secure fit, this has not been an issue with these large Spinfit tips. I think it is worth a try as an alternate way to get a good fit & seal for IEMs, and I actually prefer those rather than the Comply foam tips.
The last type of seal is the Etymotic's very deep insertion, whether using a foam tip or one of their multi-flange silicon tips. Seal and secure fit are perfect, and isolation is at a whole other level: it's like an ANC IEM !!! But one needs to be able to withstand that super deep insert (I do, but understand other won't).
What is interesting with the Etymotic's is that they are designed to work with a deep insertion: insertion depth affects the high FR response, so they are tuned accordingly. There is also a theory that, because the seal is done against the "bony part" of your ear canal, you also get better bass--so the Etymotic's are not as "bass-light" as one may think when looking at ety's FR graphs... Not sure if this is all true, but I have a pair of er4xr, and they do sound very good indeed.