It basically works as an IDE drive; as a normal 1.44M floppy drive (assuming your BIOS supports it) it can be used as your A: drive (use the LS-120 device select in your BIOS). Added capacity is realized when you use the disks made for this drive--basically, the high-capacity disks have an optical servo track added.
Legacy software for interchange (e.g. Imagedisk) won't work with it and non-standard formats do not work either. I have had the experience that some revisions will cause XP and later to hang--but this doesn't occur with all drive versions. When formatting or reading, it is much faster than a plain vanilla floppy.
Wikipedia pretty much sums it up nicely.
I'd stay away--the media is expensive and the technology has sunsetted.
FWIW, I've got a stack of Caleb UHD144 drives and media--another dead high-capacity floppy replacement.