I use it all the time, using Pocketwizards and flashes (studio flashes and speedlights).

I use a digital camera to gauge how the light actually is and to fine-tune exposure (it simply replace the old-style of using polaroid backs), then I shoot with my Canon 1v, Hasselblad 503 or my Mamiya rz67 II at the gauged aperture.

I never use TTL, only manual mode and light meters.
Automatic (TTL) flash takes away the control IMO,