First of all, a note on aquatic enviroment restrictions: Most of them are applicable only to land based creatures. If the PCs are natural to the aquatic medium, then most of the penalties for it should not be applied to themsince the were where born underwater, swiming is as natural and effortless to them as walking is for us, strong currents are like steep ladders, and they should be pretty well adapted to poor conditions of ilumination underwater. You should ignore those penalties, or apply them only when your pjsPCs step out of the water.
In the other hand, aquatic campaigns allows you to bend some rules and conventions and force the players to create characters out of their usual scope. There are some ideas to make aquatic campaing different:
Metal and wood are rare, to say the least. It is hard to make a forge work underwater, and salt water is bad for ordinary wood and metal. Items of those materials will need special treatments to avoid damage, making them rare, expensive and coveted. Alternatively, they may use things like coral and bone to create their garments, creating weapons and armors that are effective but fragile. This may lead The PjsPCs to take appropiate craft skills to equip themselves, or maintain their equipment in shape.
Water for land based creatures equals to slow and tiresome movement. Creatures adapted to aquatic enviroments, in the other side, enjoy less restricting conditions. Buoyancy allow marine creatures to reach higher sizes that land dweling creatures, while still retaining a more than respectable speed. Aquatic behemots can be surprisingly fast, and PJsPCs may need to act accordingly. By the way, wearing armor in an aquatic enviroment, unless it is really ligth, is like having a big sign on you saying "I'm slow and sluggish, please eat me".
Hack and slash is good on land, but in the water, heavy weapons are often slow and innefective. PCs may find that standard weapon choices are suboptimal in this enviroment, and will need to learn to figth with (and against) ligther or unusual weapons or tactics. Think in things like fishing nets and poison (weapon of choice for a wide range of aquatic creatures).
Magic in the water can become unpredictable. Using ligthing can be risky, fire magic fails, cold magic can fill the battlefield with blocks of ice, fog spells may react weirdly to currents, sonic spells can become empowered, etc.
This is only a fast, half-baked list of things that could be different in an aquatic campaign, and should be easy to expand or entirely replace it with a better one, with a bit of work.